Request edit access
Phi Beta Mu Xi Commissioning Project 2027
You are receiving this form because you expressed interest through our Fall 2025 Survey to join a commissioning project with the Phi Beta Mu Xi Chapter and composer Carol Brittin Chambers. The commission will be based on the Illinois state song and premiered at the All-Illinois Junior High Honor Band when she conducts in 2027 (delivered December 1, 2026).  The work would be a grade 3 - 3.5 and would be 3:00-5:00 in length.  She has agreed to a $4,000 commission - $2,000 would be covered by Phi Beta Mu Xi Chapter (Illinois) and the remaining $2,000 will be reached via a consortium of twenty middle and high school directors affiliated with Phi Beta Mu Xi each paying $100.
Sign in to Google to save your progress. Learn more
Your First Name *
Your Last Name *
Your Office Phone *
Your Work Email *
School Information for Billing
We will provide an invoice as well as a digital payment link
School Name *
Street Address *
City *
State *
Zip Code *
Main Office Number *
Billing Contact Name - Addressed to Who's Attention? *
Commission Information
For the inside of the program
Director(s) Full Names as you would like them to appear *
School Full Name as you would like it to appear *
Ensemble Name or Organization Name as you would like it to appear *
Payment Information
We will provide an invoice along with a payment link.  Payments can be made via check made payable to "Phi Beta Mu Illinois Chapter" or via the online payment link.  More info to follow! *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report